Midwives fail to keep pace with birth rate

A new analysis of the midwifery workforce shows it is ageing and failing to keep pace with the birth rate.

Like many parts of the health workforce internationally, midwifery is short-staffed.

In some parts of NZ, including Counties Manukau, the shortage of community midwives is so severe that the Health Ministry has granted an exemption to health boards from its rule designed to ensure a woman has the same lead maternity caregiver throughout pregnancy and birth.

The 2002-2004 analysis by the College of Midwives for the ministry is to be released in full this week, but the college has given a preview to the Herald.

It says annual growth in the active midwifery workforce, of 2.1 per cent, has fallen behind the 3.75 per cent annual increase in the birth rate in the past three years.

"For us, the report confirmed what we have been saying for some years," said college adviser Norma Campbell.

But the ministry's chief adviser on child and youth health, Pat Tuohy, said the birth rate was projected to decline towards 2010.

The analysis also found the average age of midwives was 47.

Jackie Gunn, midwifery head at Auckland University of Technology, said the average age had increased significantly in recent years, reflecting the rising age at which students had been entering the three-year degree course. Many of the students were women attracted to midwifery after having their own children.

The report estimates that 154 to 174 midwives leave the profession each year. While 200 to 220 enter and register annually, the number of practising midwives has increased by only 46 a year on average since 2002. Typically around 100 of the newly registered midwives each year are from overseas.

The college recommends a case-load of 50 births a year, but the average in the analysis was 64.

Tony Mansfield, general manager of SAMCL, a support agency for 325 midwives, said some had had case-loads of more than 80, but had cut back - although they would not have delivered all of the babies, hiring locums in some cases.

Some midwives had given up because of the stress of the job, he said.

Mrs Gunn said recent adverse publicity might be turning people off a career in midwifery. Applications to AUT for this year's intake were down 20 per cent on the usual level.

Dr Tuohy said a number of things that might help keep more midwives in the workforce had started or were being looked at, including the development of support agencies like SAMCL.